AB1113 REAL-WORLD USAGE OF BIOLOGIC DISEASE-MODIFYING ANTIRHEUMATIC DRUGS IN PATIENTS WITH PSORIATIC ARTHRITIS IN SWEDEN
Authors: J. Song, C. Abé, J. Banefelt, A. Rieem-Dun, D. Willems, M. Morup, V. Taieb, I. Lindberg, S. Welby
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Given the growing number of treatment options for psoriatic arthritis (PsA) over the last decades, including a variety of biologic disease-modifying anti‑rheumatic drugs (bDMARDs), selecting optimal treatment regimens is critical. Beyond clinical guidelines, understanding how physicians choose between available treatment options based on patient characteristics in real-world settings is of interest to both patients and health care providers. <h3>Objectives</h3> To reveal the patient characteristics (ie. demographics, comorbidities – including concomitant psoriasis [PSO], PsA+PSO and history of bDMARD exposure) in relation to bDMARD type and dosing in patients with PsA, treated in real-world clinical practice. <h3>Methods</h3> This retrospective observational cohort study utilised data from Swedish national administrative health care registers. Adult patients with an existing PsA diagnosis and a new bDMARD pharmacy dispensation between 2017–2021 were identified. Index date was that of the first observed dispensation qualifying as a new bDMARD, ie, without prior exposure to the index biologic. Prior bDMARD exposure and patient characteristics (including comorbidities) were screened for from 2005 and 2001, respectively. For patients initiating secukinumab (SEC), prescribed dosing was reported separately for patients with and without PSO manifestations given the variability in prescribing recommendations. <h3>Results</h3> This study identified 8,658 PsA patients initiating a new bDMARD during the study period, among which 2,706 (31.3%) were already bDMARD-experienced. Patients had a mean age of 52.3 years (SD=13.7), and 45.1% were male. The most frequently prescribed bDMARDs were adalimumab (45.3%), etanercept (31.8%), and SEC (11.3%). As expected, due to their recent market authorisations in PsA, the least frequently prescribed bDMARDs were guselkumab (0.8%) and risankizumab (0.4%). The most frequently observed prescriber speciality was rheumatologist (46.1%). The highest proportion of bDMARD-experienced patients was observed amongst interleukin-17 inhibitors initiators (82.4%), while 19.7% of tumour necrosis factor inhibitor initiators were bDMARD-experienced. Overall, 62.8% of patients had PsA+PSO. Other frequent non-inflammatory comorbidities included hypertension (22.0%), malignancies (12.6%), and depression (11.7%). The proportion of patients with anxiety and depression was higher among those initiating risankizumab compared to those initiating other bDMARDs. Other comorbidities were comparable between groups. Amongst 981 SEC initiators, 679 (69.2%) had PsA+PSO. Maintenance dose data were available/could be analysed for 901 patients. Most PsA-only patients-initiated SEC at a dose of 150 mg (53.7%), and most PsA+PSO at 300 mg (65.0%). This was similar for maintenance period with 51.8% percent of PsA-only and 62.4% of PsA+PSO patients receiving a maintenance dose of 150 mg and 300 mg, respectively. A similar pattern was observed within bDMARD-naïve and bDMARD-experienced patients regardless of PSO manifestations. <h3>Conclusion</h3> This study provides information on the profiles of PsA patients treated with different bDMARDs and suggest that factors such as PSO manifestations and biologic-experience play important roles in the choice of bDMARD and dosing regimen. Future studies are warranted to identify patient outcomes associated with treatment patterns, including discontinuation and switches over time, which can assist in tailoring therapies to patient needs. <h3>Acknowledgements</h3> This study was funded by UCB Pharma. Medical writing support provided by Quantify Research and funded by UCB Pharma. Publication management support provided by Costello Medical and funded by UCB Pharma. <h3>Disclosure of Interests</h3> Jie Song Employee of: UCB Pharma, Christoph Abé Employee of: Employee of Quantify Research, a contract research organization that provides consultancy services to the pharmaceutical industry, Jonas Banefelt Shareholder of: Stockholder of Quantify Research, Employee of: Employee of Quantify Research, Alexander Rieem-Dun Employee of: Employee of Quantify Research, a contract research organization that provides consultancy services to the pharmaceutical industry, Damon Willems Shareholder of: Stockholder of UCB, Employee of: Employee of UCB, Michael Morup Employee of: Employee of UCB Pharma, Vanessa Taieb Employee of: Employee of UCB Pharma, Ingrid Lindberg Employee of: Employee of UCB Pharma, Sarah Welby Shareholder of: UCB Pharma, GSK, Employee of: UCB Pharma.